T&O: Bone Infections Flashcards Preview

3.1. Surgery > T&O: Bone Infections > Flashcards

Flashcards in T&O: Bone Infections Deck (11)
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1
Q

Acute osteomyelitis: sources and organisms

A

Can be local (from surgery) or haematogenous

Organisms: staph aureus (main one), strep, E. coli, pseudomonas, salmonella

2
Q

Acute osteomyelitis: risk factors

A

vascular disease, trauma, immunosuppression, children (rich blood supply to growth plate)

systemic disease

3
Q

Acute osteomyelitis: signs and symptoms

A

Pain, tenderness, erythema, warmth, decreased ROM

Effusion in neighbouring joints

Signs of systemic infection/coryzal symptoms

4
Q

Acute osteomyelitis investigations

A

Raised ESR/CRP/WCC

Positive blood cultures in 60% of pts

X-ray: haziness + decreased bone density, sub-periosteal reaction

MRI: sensitive and specific

5
Q

Acute osteomyelitis management

A

IV ABX Vanc+cefotaxime (check local trust guidelines!)

may take several weeks

Drain abscess and remove sequestration

Analgesia

6
Q

Septic arthritis: source, differential and organisms

A

Source: local or haematogenous

Differential: crystal arthropathy, reactive arthritis

Organisms: staph (60%), streps, gonococcus, gram -ve bacilli

7
Q

Septic arthritis: risk factors and symptoms

A

Risk factors: joint disease (RA), chronic renal failure, immunosupression, prosthetic joints

Symptoms: acutely inflamed, tender, swollen joint, decreased ROM, systemically unwell

8
Q

Septic Arthritis investigations

A

Joint aspiration for MCS

Raised ESR/CRP, blood cultures

X ray

9
Q

Septic arthritis: Mx and complications

A

IV ABX

Consider joint washout under GA

Splint joint

Physio after infection resolved

Complications: osteomyelitis, Arthritis, ankylosis (fusion)

10
Q

Avascular necrosis: pathophysiology

A

Disruption of blood supply either due to interruption of arterial inflow (fracture) or blockage of venous outflow (infiltrative disorders)

11
Q

Avascular necrosis: causes

A

Fracture/dislocation

Sickle cell disease: clumping of RBCs leads to diminished capillary flow - infarcted areas of bone become infected with unusual organisms such as salmonella

Decompression sickness/Caisson disease/Bends

Gaucher’s disease: rare familial disorder of lipid metabolism - blocks venous outflow

Drug induced: esp corticosteroids

Idiopathic

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